Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 109462 | AK |
NPI | 1437542594 |
---|---|
Provider Name | Dr. Raymond Reeves |
First Address | Haines, AK 99827-1529 |
Second Address | Haines, AK 99827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2015 |
Last Update Date | 02/09/2016 |